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UGS Anatomy 1
Urogenital System Anatomy- Urinary System
| Question | Answer |
|---|---|
| The Kidney is made up of an outer ______ and inner _____ | Cortex, Medulla |
| The sections of the renal cortex between the pyramids of the medulla are called: | Renal columns |
| A renal pyramid and its surrounding column is called a: | Renal lobe |
| Generally, what is the ureter? | The duct of the kidney |
| The part of the ureter which runs in the kidney is called the: | Pelvis of the ureter/ Renal pelvis |
| The ureter is made up of : | 2 major calyces |
| The Major calyces are each formed of: | 3-4 minor calyces |
| At the apex of each renal pyramid are the: | Renal Papilla |
| The renal papilla opens into the; | Minor calyces |
| How many nephrons make up a single kidney? | About 1 million |
| Each nephron and collecting duct make up: | Urinoneprhous tube |
| The renal corpuscle is contained in the: | Nephron |
| The renal corpuscle is made up of 2 parts, which are: | The glomerulus and Bowman's capsule |
| The glomerulus is a tuft of: | Capillaries |
| The afferent arterioles have a wider diameter than the efferent arterioles. What purpose does this serve? | The wider diameter of the afferent arterioles allows for a greater BP, which increases the force of filtration |
| The glomerulus is surrounded by: | Bowman's Capsule |
| The glomerulus opens into: | The proximal convoluted tubules |
| The PCT open into the: | Loop of Henle |
| The Loop of Henle is made up of 3 parts, which are: | 1) The thin descending segment 2) The thin ascending segment 3) The thick ascending segment |
| The last part of the loop of Henle opens into the: | Distal convoluted tubules |
| The Distal convoluted tubules open into the: | Collecting duct |
| What is fluid into the glomerulus? | Plasma without plasma proteins |
| Why do the plasma and filtrate have equal osmolarity? | Due to the free filtration of water and solutes throughout the renal tubules |
| Which substances in the plasma are completely reabsorbed in the nephrons? | Glucose and amino acids |
| Which reabsorbed substance is the MOST important function of the kidney? | Sodium |
| Why is sodium reabsorption important? | Sodium maintains the EC volume, which means that its maintains blood volume. Maintenance of blood volume aids in maintaining blood pressure. |
| What are the layers of Bowman's Capsule? | A visceral and parietal layer |
| The visceral layer lies just above: | The thickened glomerular basement membrane |
| The visceral layer is made up of: | Podocytes (Visceral layer= glomerular epithelium) |
| Beneath the visceral layer, there are: | Glomerular capillaries |
| Deep to the glomerular capillaries are the: | Podocytes |
| Podocytes are separated from the capillaries by: | Primary processes |
| Primary processes wrap around the capillaries and form: | Secondary processes / pedicles |
| What structures make up the filtration barrier of the glomerulus? | Fenestrated epithelium of the glomerular capillaries, the fused basal lamina of the endothelial cells, podocytes, and the filtration slits of podocytes |
| The filtration barrier allows the passage of what substances? | Water, ions, and small molecules from the bloodstream |
| The filtration barrier PREVENTS the passage of what substances? | Large and/or negatively charged proteins (such as albumin) |
| The filtration pore or slit should allow the passage of molecules under 160000 microns, so why doesn’t it allow the passage of albumin? | Because albumin is negatively charged, as is the filtration barrier, so repulsion of like charges occurs |
| What is the main blood supply of the kidney? | The renal artery, which originates from the abdominal aorta |
| What are the main divisions of the renal artery? | Anterior and Posterior |
| The anterior part of the renal artery is divided into: | 4 segmental arteries |
| The posterior part of the renal artery is divided into: | 1 segmental artery |
| What is the pathway of oxygenated blood through the kidney? | Renal artery --> Segmental artery --> Lobar artery -->Interlobar artery --> Arcuate artery --> interlobular artery --> Afferent arterioles --> efferent arterioles -->vasa recta |
| Where are the vasa recta located? | Around the Loop of Henle in Juxtamedullary nephrons |
| What are the two types of nephrons in the kidney? | Cortical and Juxtamedullary nephrons |
| What is the most common type of nephron in the kidney? | Cortical nephrons at 80-85% |
| What is the main difference between the types of the nephrons? | Juxtamedullary nephrons have a longer Loop of Henle and produce concentrated urine |
| What are the two types of capillaries in the nephrons? | Glomerular capillaries and peritubular capillaries |
| What is the function of peritubular capillaries? | Reabsorption of water, glucose, and salts |
| High BP aids in the process of filtration, while low BP aids in the process of : | Reabsorption |
| What fraction of the cardiac output supplies the kidneys? | 1/4 Almost 1200 or 1100 mL |
| What percentage of the blood entering the kidney is plasma? | 57% 625 mL |
| What percentage of the plasma entering the kidney is filtered? | 20% 125 mL |
| What is the glomerular filtration rate of the kidney? | 125 mL/min |
| How much of the GFR makes up urine? | 1 mL out of 125 mL/min |
| What are the 3 stages of Urine formation? | Filtration, reabsorption, and secretion |
| What are the daily filtered substances and their amounts? | 180L of water 680g of Na 180g of glucose 54g of urea |
| What are the percentages of reabsorption for filtered substances? | 99% of water is reabsorbed 99.5% of sodium is reabsorbed 100% of glucose and amino acids are reabsorbed 44% of urea is reabsorbed |
| How do we find the filtration fraction? | GFR/RPF |
| What is the normal filtration fraction? | 0.2 or 20% |
| How many renal pyramids is the medulla made up of? | 12 |
| Extending from the base of the renal pyramid to the cortex are striations called: | Medullary rays |
| Medullary rays and associated tubules are called: | Renal lobules |
| The contractile, phagocytic cells between the glomerular cells are the: | Mesangial cells |
| Mesangial cells support the capillary walls by: | Producing Intracellular substance |
| How much glomerular filtrate is produced per 24 hours? | 180 L |
| What percentage of renal blood flow perfuses the medulla and how? | 5% Via the vasa recta |
| Which forces favor filtration? | Glomerular blood hydrostatic pressure 45 mmHg |
| Which forces oppose filtration? | Capsular hydrostatic pressure (10mmHg) and Blood Colloid osmotic pressure in the glomerulus (19mmHg) |
| What is the effect of constriction of afferent arterioles on GFR, RPF, and FF? | Decreased RPF and GFR Same FF |
| What is the effect of constriction of efferent arterioles on GFR, RPF, and FF? | Decreased RPF Increased GFR Increased FF |
| What is the effect of increased plasma protein concentration on GFR, RPF, and FF? | No change in the RPF Decreased GFR Decreased FF |
| What is the effect of decreased plasma protein concentration on GFR, RPF, and FF? | No change in the RPF Increased GFR Increased FF |
| What is the effect of constriction of the ureter on GFR, RPF, and FF? | No change in the RPF Decreased GFR Decreased FF |
| Describe the histology of proximal convuluted tubules: | Stellate shaped Lumen Bound by a distinct brush border Cuboidal or low Columnar cells with indistinct lateral cell boundaries |
| Why does the cytoplasm of the PCT stain dark with eosin? | Due to the large amount of mitochondria in the cell |
| What distinctive appearance is seen around the PCT? | PAS-positive basal lamina |
| Describe the EM appearance of the PCT: | 1) Apical golgi apparatus and basal mitochondria 2) Infolding and interdigitating at the base of the cell 3) Long, densely-packed microvilli at the apex 4) Apical canilliculi which form vesicles at the clefts in the base of the microvilli |
| What is the endocytic complex of the PCT made up of? | 1) Apical canaliculi 2) Vesicles 3) Vacuoles |
| What is the function of the endocytic complex and how is it performed? | Protein absorption Vacuoles condense and fuse with lysosomes, the acid hyrolases of which reduce the absorbed proteins to amino acids which are then released into the blood stream |
| Which substances are reabsorbed by the PCT? | 65% of water, sodium, chloride, and potassium ALL glucose, and amino acids |
| What is the main mechanism of reabsorption of substances in the PCT? | Sodium cotransport, antiport, or Na-K ATPase channels Water reabsorption follows solute transport |
| What is the effect of the reabsorption of Sodium and other solutes in the PCT? | Increased osmolarity of the lateral intracellular space making the IC space slightly hyperosmotic at -3 mOsm/Kg H2O |
| What is the difference between the two halfs of the PCT? | The first half mostly involves the reabsorption of Na along with bicarbonate The rise in Cl- leads to a favorable gradient for Cl- reabsorption with Na in the second half --> passive diffusion |
| Renal tubular epithelial cells are held together by: | Tight junctions |
| Renal tubular epithelial cells are separated by: | Intracellular spaces |
| Secretion or reabsorption via renal tubular cells is done across cells via the: | Transcellular pathway |
| Secretion or reabsorption via renal tubular cells is done between cells via the: | Paracellular pathway |
| Na reabsorption via the transcellular pathway depends on: | Na-K-ATPase 1) Movement across apical membranes down an electrochemical gradient established by NA-K-ATPase 2) Movement across the basolateral membrane against an electrochemical gradients |
| What are the Na co-transport proteins? | Na-glucose Na-Amino acids Na-phosphate Na-Cl- |
| What are the Na anti-porters? | Na-H+ (Bicarboncate reabsorption) |
| How do we maintain water and increase the concentration of urine? | By utilizing the Loop of Henle, the Vasa Recta, and ADH |
| What is a cause of diabetes insipidus related to urine concentration? | ADH deficiency |
| A renal lobe is bounded by what? | Interlobar arteries |
| What is the length and diameter of PCT? | Length: 15mm Diameter: 60 microns |
| What is the length and diameter of DCT? | Length: 8mm Diameter: 30 microns |
| What is the type of epithelium in the PCT and DCT? | Transitional epithelium between cuboidal and low columnar epithelium |
| How can you differentiate between the PCT and DCT histologically? | PCT: Brush border made up of continuous microvilli DCT: No brush border and there are few microvilli |
| The tight junction in the PCT are described as: | Leaky |
| Why is there a gradient across the apical membrane of renal tubular cells? | In the cell, Na concentration is 12 mmol/L and In the filtrate, Na concentration is 140 mmol/L which forms a gradient allowing sodium to travel across the apical membrane in downhill movement |
| What is the osmolarity of the filtrate in the proximal tubule? | 300 mmol/kg of water |
| Which of the segments of the Loop of Henle is permeable to water? | The Thin Descending Segment |
| Which of the segments of the Loop of Henle contains the most hypertonic fluid? | The Thin Descending Segment |
| How much water is reabsorbed in the Thin Descending Segment? | 15% of the total water reabsorbed |
| What is the concentration of solutes around the ThinkDescending Segments? | 600 mosmol of urea outside 300 mosmol Na/Cl |
| Which of the segments of the Loop of Henle is impermeable to water? | The thin and thick ascending segments |
| How does the concentration of the filtrate vary as it passes through the Loop of Henle? | It becomes more hypotonic |
| What is the concentration of solutes around the Think Ascending Segment? | 600 mosmol of Na/Cl inside 100 mosmol outside |
| How are solutes reabsorbed in the Loop of Henle? | Symporter --> one carrier carries K+/Na+/Cl- -Increased K+ concentration in the cell causes K+ to move into the filtrate Antiporter --> Na reabsorbed, H+ released |
| What is unique about K+ in the Loop of Henle? | It is reabsorbed AND secreted |
| What are the main parts of the DCT? | 1) Early Segment 2) Macula Densa 3) Late segment |
| What are the characteristics of the Early segment of the DCT? | It's a continuation of the thick ascending segment Known as the diluting cortical segment Reabsorption of Na and K+ |
| The Macula Densa is part of the: | Juxtaglomerular apparatus |
| What is an importance of the late segment of the DCT? | Acid/Base balance |
| The Late segment is similar to the: | Collecting tubule and duct |
| What are the types of cells in the late segment? | Principle cells Intercalated cells |
| What is the histologic appearance of the principle cells? | They are light staining and have clear boundaries |
| Principle cells act mainly under the effect of: | ADH |
| What solutes are exchanged in the principle cells? | K+ is secreted Na+ is reabsorbed (3%) |
| What solutes are exchanged in the intercalated cells? | K+ is secreted and reabsorbed Secrete H+ |
| What is the effect of Loop Diuretics on Na reabsorption? | Prevention of Na reabsorption at the thick ascending segment of the Loop of Henle |
| Which is the effect of Thiazide diuretics on Na reabsorption? | Prevent Na reabsorption in the early distal convoluted tubules |
| What is the effect of Potassium-sparing diuretics on Na reabsorption? | Prevent Na reabsorption in the principle cells |
| When does the filtrate reach isotonicity in the tubules? | At the cortical collecting ducts (the distal convoluted tubule) |
| What are the main functions of ADH and where is its main sight of action? | Maintenance of body water and increases concentration of urine via increased reabsorption of water in the Loop of Henle, Vasa Recta, and collecting ducts |
| How do the vasa recta contribute to maintenance of body water? | By making sure minimal blood enters the medulla and minerals aren’t washed away |
| The hyperosmolarity of urea is due to: | reabsorption of urea and NaCl |
| What is the difference between urea and plasma osmolarity? | Urine is 4x the hyperosmolarity |
| What is the only site of reabsorption of urea? | At the end of the collecting duct |
| What are juxtaglomerular cells? | Modified smooth muscles |
| Juxtaglomerular cells contains granules which secrete: | Rennin |
| When is rennin secreted? | In case of Na, BP, or ECF volume decrease |
| Rennin secretion leads to formation of which hormone? | Angiotensin 2 |
| What are the effects of angiotensin? | 1) Vasoconstriction of vessels ïƒ Increased BP 2) Release aldosterone from the renal cortex – which stimulates sodium reabsorption 3) Stimulate release of ADH ïƒ Increased water reabsorption ïƒ Increased ECF |
| ADH has no effect on which renal tubules? | The proximal convoluted tubules or thin descending segment of the loop of Henle |
| What are the causes of Diabetes Insipidus? | 1) ADH being ineffective on tubules causing nephrogenesis 2) ADH not being present |
| What is the position of the kidneys relative to the peritoneum? | Retroperitoneal |
| The kidney is adjacent to which vertebrae? | T12-L3 |
| What are the dimensions of the kidneys? | 11 x 6 x 3 11 cm in length, 6 cm in width, 3 cm in girth |
| Which kidney is lower than the other? | The right kidney because it is being 'pushed' down by the liver |
| What is the position of the kidneys relative to the ribs? | The right kidney has one rib behind it (the 12th rib) and the left kidney has 2 ribs behind it (the 11th and 12th ribs) The kidney is separated from the ribs by the diaphragm |
| Which gland lies above the kidneys? | Suprarenal/ Adrenal glands |
| What are the two borders of the kidney? | An inner concave border and an outer convex border |
| What is the importance of the renal fascia surrounding the kidney? | It separates the kidney from the suprarenal gland It continues as the transversalis fascia |
| Ptosis of the kidney or slight descent of the kidney can normally occur due to: | Sudden weight loss |
| The lower half of the kidney is related to which muscles? | The psoas major The diaphragm The quadratrus lumborum The transversus abdominus |
| How is a pneumothorax related to kidney injury? | Both can be caused by rib fracture (more likely a fracture of the 11th rib, than the 12th) |
| What is the most anterior structure coming from the hilum of each kidney? | The renal vein |
| Which renal vein is longer and why? | The left vein is longer than the right vein because the veins drain into the inferior vena cava and the IVC lies closer to the right kidney, and therefore, the right renal vein |
| When is the surface area of glomerular capillaries maximum? | When the mesangial cells are relaxed |
| How do the mesangial cells regulate the SA of glomerular capillaries? | Contraction of mesangial cells reduces the available surface area, and glomerular filtration decreases |
| What is the thickness of the filtration membrane? | 0.1 microns |
| How are the PCT differentiated from the DCT? | The lumen of the DCT is usually wider Cells are shorter and lighter stained Nuclear profiles are seen in every cell, in part because every cell is binuclear A brush border is lacking |
| What are the ureters? | Muscular tubes which conduct urine from the kidneys to the bladder |
| How is urine propelled throughout the ureter? | Via peristalsis |
| The muscles in the wall of the ureter are separated into: | An inner longitudinal layer and an outer circular layer |
| What are the surfaces of the kidney? | Anterior and posterior |
| What are the poles of the kidney? | Upper and lower poles The upper pole leans towards the midline, while the lower pole leans away |
| How much does the kidney weigh? | 150 grams |
| How can you differentiate between the surfaces of the kidney? | The anterior surface is irregular, while the posterior surface is flat |
| How can you differentiate between the poles of the kidney? | The upper pole of the kidney is broad, while the lower pole is pointed |
| What are the three layers of tissue surrounding each kidney? | 1) The deep layer, the renal capsule or fibrous capsule 2) The middle layer, the adipose capsule or perirenal fat 3) The superficial layer, the renal fascia |
| What is the renal capsule? | A smooth, transparent sheet of dense irregular connective tissue that is continuous with the outer coat of the ureter |
| What is the purpose of the renal capsule? | It serves as a barrier against trauma and helps maintain the shape of the kidney. |
| The renal capsule only adheres to the kidney in case of: | Inflammation |
| What is the adipose capsule? | A mass of fatty tissue surrounding the renal capsule or fibrous capsule |
| What is the purpose of the adipose capsule? | It also protects the kidney from trauma and holds it firmly in place within the abdominal cavity |
| What is the renal fascia? | A thin layer of dense irregular connective tissue |
| What is the purpose of the renal fascia? | It anchors the kidney to the surrounding structures and to the abdominal wall |
| What are the relations of the renal fascia? | Anterior: Peritoneum Above: Blends with fascia over the diaphragm Medial: blends with the sheaths of the aorta and the IVC Lateral: Continuous with the transversalis fascia |
| What are the contents of the hilum of the kidney from anterior to posterior? | Renal vein, renal artery, and the renal pelvis |
| What are the potential locations of the pelvis of the ureter? | Completely outside the substance of the kidney or buried in the renal hilum or anywhere in between |
| Which ureter position allows for easy stone removal? | Extra-renal |
| What are the peritoneal relations of the kidney? | Partly covered by peritoneum anteriorly Between the liver and kidney is a part of the peritoneal cavity called hepatorenal pouch Between the stomach and the kidney is the lesser sac The stomach and the spleen are separated by the greater sac |
| What are the anterior relations of the right kidney? | Suprarenal gland, liver, second part of duodenum, and right colic flexure |
| What are the posterior relations of the right kidney? | Diaphragm, 12th rib, costodiaphragmatic recess of the pleura, psoas muscle, quadratus lumborum muscle, and transversus abdominus muscle |
| What are the anterior relations of the left kidney? | Suprarenal gland, spleen, stomach, pancreas, left colic flexure, and coils of jejunum |
| What are the posterior relations of the left kidney? | Diaphragm, costodiaphragmatic recess of the pleura, 11th and 12th rib, psoas muscle, quadratus lumborum muscle, and transversus abdominus muscle |
| What are the posterior relations of both kidneys? | Subcoastal vessels Subcoastal, iliohypogastric, and ilioinguinal nerves |
| What does the abberant renal artery supply? | The superior and or inferior pole of the kidney |
| How common is the presence of an accessory renal artery? | It is present in 25-30% of the population |
| The accessory renal artery usually supplies: | The renal artery |
| Do accessory renal arteries occur unilaterally or bilaterally usually? | Unilaterally Occur Bilaterally in 15% of cases |
| In most cases, where does the accessory renal artery arise from? | The abdominal aorta as a single artery and supplies the inferior pole of the kidney |
| What is the position of the ureters relative to the peritoneum? | They lie beneath the peritoneum |
| What body walls are the ureters attached to? | The posterior abdominal wall in the upper part and the lateral pelvic wall in the lower part |
| How long are the ureters? | 25 cm or 10 inches |
| What is the diameter of the ureters? | 3mm |
| What is the type of epithelium in the ureters? | Transitional urinary epithelium Cuboidal to low columnar |
| How many layers of muscle are in the wall of the ureters? | The muscles in the wall of the upper 2/3 of the ureter is made of 2 layers- inner longitudinal and outer circular. In the lower 1/3 of the ureter, there are 3 layers- inner longitudinal, middle circular, outer longitudinal (just like urinary bladder) |
| How do the ureters enter the pelvis? | The ureter crosses the end of the common iliac artery to enter the pelvis It passes downward and backward following the anterior margin of the greater sciatic notch |
| Where does the ureter enter the bladder? | Opposite the ischial spine, it turns forward and medially to reach the base of the urinary bladder It passes obliquely in the wall of the bladder for 1 inch before it opens at the side of the trigone |
| Where are the constriction of the ureter? | 1) At the beginning of the ureter proper 2) At the pelvic brim 3) Where the ureter enters the bladder |
| What are the posterior relations of the abdominal ureter? | Psoas Muscle Genitofemoral nerve Common iliac vessels Tips of L2-L5 transverse processes |
| What are the anterior relations of the right abdominal ureter? | Descending duodenum Ileum and root of mesentery Gonadal vessels Right colic vessels ileocolic vessels |
| What are the anterior relations of the left abdominal ureter? | Gonadal artery Left colic artery Loop of Jejunum Sigmoid mesentery Pelvic colon Mesocolon |
| What are the medial relations of the right abdominal ureter? | IVC |
| What are the medial relations of the left abdominal ureter? | Abdominal aorta Inferior mesenteric vein |
| What are the posterior relations of the pelvic ureter? | Sacroiliac joint Internal iliac artery |
| What are the inferior relations of the pelvic ureter in the male? | Seminal vesicles |
| What are the inferior relations of the pelvic ureter in the female? | Lateral fornix of the vagina |
| What are the anterior relations of the pelvic ureter in the male? | Ductus deferens |
| What are the anterior relations of the pelvic ureter in the female? | The uterine artery contained in the broad ligament |
| What are the medial relations of the pelvic ureter in the female? | Cervix |
| What is the relationship of the ureter to the supravaginal part of the cervix? | The ureter lies 2 cm lateral to it |
| What is the relationship of the ureter and the vagina? | The ureter runs slightly above the lateral fornix of the vagina |
| The blood supply of the upper part of the ureter is the: | Renal artery |
| The blood supply of the middle part of the ureter is the: | Aorta |
| The blood supply of the pelvic ureter is the: | Vesical and uterine vessels from the internal iliac artery |
| What is the nerve supply of the ureter? | The sympathetic T10-L1 nerves |
| Pain from the kidney and the extreme upper end of the ureter is felt at: | Yhe back near the costovertebral angle |
| Pain from the middle and distal parts of the ureter is referred to the: | The lower part of the abdominal wall, genital areas, or the inner aspect of the thigh |
| What is the difference between the location of the urinary bladder at birth and in adulthood? | The urinary bladder is a pelvic organ in adults, but an abdominal organ at birth |
| When does the urinary bladder sink into the pelvic cavity? | By the 6th year of life |
| How many surfaces, angles, and ducts does the urinary bladder have? | 4 of each |
| What are the 4 surfaces of the bladder? | 1) A superior surface 2) 2 inferolateral surfaces 3) An inferoposterior surface/ base |
| What is the shape of the surfaces of the bladder? | Triangular |
| What are the 4 angles of the bladder? | 1) The anterior angle/ apex 2) The inferior angle/neck 3) 2 Postero-Superior angles |
| What are the 4 ducts of the urinary bladder? | 1) 2 ureters 2) Urethra 3) Urachus |
| Where on the bladder are the ureters attached? | To the posterosuperior angles |
| Where on the bladder is the urethra attached? | Neck of the bladder |
| Where on the bladder is the median umbilical ligament attached? | To the apex |
| What are the relations of the superior surface of the bladder in males? | Coils of the pelvic colon Terminal coils of the ileum |
| What are the relations of the superior surface of the bladder in females? | The uterus but is separated from it by the uterovesical pouch, which may contain coils of intestine |
| What are the infero-lateral relations of the bladder in both sexes? | In front, the sides lie in contact with the retropubic pad of fat and the bare pubic bone More posteriorly, they become related to the obturator internus above and the levator ani below |
| What are the relations of the base of the bladder/ inferoposterior surface in males? | Anterior surface of the rectum, but the rectum is separated from the bladder by the 2 vasa deferentia and the 2 seminal vesicles |
| What are the relations of the base of the bladder in females? | Anterior surface of the vagina, separating the bladder from the rectum |
| What are the relations of the neck of the bladder in males? | It lies on the prostate |
| What are the relations of the neck of the bladder in females? | It lies on the pelvic fascia |
| What are the peritoneal relations of the empty bladder? | The superior surface and the upper inch of the base are covered by peritoneum |
| What are the peritoneal relations of the full bladder? | When the bladder rises, it raises the peritoneum from the anterior abdominal wall so that it is in direct contact with the transversalis fascia for about 1 and 1/2 inches above the pubic bone |
| What is the difference between the mucous membrane of the bladder when it is full or empty? | The main part of the mucous membrane is irregular and thrown into folds called rugose to increase the surface area When the bladder becomes full, the irregularity disappears and the mucous membrane becomes smoother |
| What par of the bladder is always smooth? | The trigone |
| The trigone corresponds to what part of the bladder on the outside? | Base |
| What are the points of the trigone made up of? | The openings of the ureters, and the internal meatus of the urethra/ internal urethral orifice |
| Between the openings of the 2 ureters, there is a raised fold of mucous membrane called: | The intrauretric ridge |
| Immediately behind the opening of the urethra is a small rounded elevation called the: | Uvula vesicae |
| The uvula vesicae is caused by the: | Underlying median lobe of the prostate |
| Which structure is posterior to the urinary bladder? | Prostate |
| What is an important cause of urinary retention in the elederly? | Due to senile enlargement of the prostate, the median lobes are also enlarged and this causes urine to accumulate behind the uvula vesica |
| How is the inside of the urinary bladder examined? | Via cytoscopy |
| What is the distance between the 2 ureters when the bladder is empty and when it is distended? | 1 inch when it is empty and 2 inches when it is distended |
| What is the function of the urethra in males? | External discharge of urine and seminal fluid |
| What is the length of the male urethra? | 18-20 cm |
| In the flaccid penis, how many curvatures are there in the urethra? | 2 curvatures forming an S shape |
| How many curvatures are there in the urethra of the erect penis? | 1 The distal curve is obliterated and it forms a J shape |
| Where does the male urethra begin and where does it end? | It begins at the internal urethral orifice at the neck of the bladder and ends in the external urethral orifice at the tip of the penis |
| During the course of the male urethra, it passes through: | The prostate, sphincter urethra, and the corpus spongiosum penis |
| What are the 3 parts of the male urethra? | 1) Prostatic urethra 2) Membranous urethra a 3) Penile urethra |
| How long does the prostatic urethra extend for? | 3 cm |
| What are the characteristics of the prostatic urethra? | It is the widest and most dilatable part of the urethra |
| What is the shape of the prostatic urethra? | Semilunar in shape on transverse section and is convexly directed forward |
| The posterior wall of the prostatic urethra is made up of: | The urethral crest, the colliculus seminalis, and the prostatic sinuses |
| What is the urethral crest? | A median longitudinal ridge of mucous membrane |
| What is the colliculus seminalis? | An elevation in the middle of the urethral crest |
| What are the openings in the colliculus seminalis? | A slit-like orifice where the prostatic utricle is situated and openings to the ejaculatory ducts on either side |
| What are the prostatic sinuses? | Two vertical grooves which present about 20-30 opening of the prostatic glands each |
| What is the prostatic utricle? | A blind sac, about 6 mm long, which lies within the prostate It is directed upwards and backwards between the median and posterior lobes of the prostate It is homologous with the uterus |
| How long is the membranous urethra? | 1.5-2 cm long |
| What is pierced by the membranous urethra? | The perineal membrane about 2.5 cm below and behind the pubic symphysis |
| What are the characteristics of the membranous urethra? | It is the narrowest part and least dilatable part of the male urethra |
| What is the shape of the membranous urethra? | On transverse section, it is star-shaped |
| The membranous urethra is surrounded by: | The sphincter urethra |
| Which glands are on either side of the membranous urethra? | The bulbourethral glands of Cowper |
| The ducts of the bulbourethral glands of Cowper open into | The spongy part of urethra 2.5 cm after piercing the perineal membrane |
| How long is the penile urethra? | 15 cm |
| What is the path of the penile urethra? | The fixed part of the penile urethra runs forwards and upwards in the bulb of the penis It bends downwards in front of the lower part of pubic symphysis to continue as the free part of the penile urethra in the corpus spongiosum penis |
| What is the diameter of the penile urethra? | 6 mm |
| The penile urethra is dilated within the glans penis to form: | The navicular fossa |
| There are several small pit-like recesses in the urethral mucous membrane called: | Lacunae of Morgagni |
| The largest lacuna of Morgagni is | The Lacuna Magna or sinus of Guerin |
| What are the sphincters of the urethra? | Internal Urethral Sphincter/ Sphincter Vesicae External Urethral Sphincter/Sphincter Urethra |
| Why is the internal urethral sphincter involuntary? | Because it is supplied by the lower thoracic and upper lumbar sympathetic nerves |
| What does the internal urethral sphincter control? | The neck of the bladder and prostatic urethra above the opening of ejaculatory ducts |
| What is the internal urethral sphincter made up of? | Smooth muscle fibers with considerable elastic and collagenous fibers |
| The external urethral sphincter is voluntary because: | It is made up of striated voluntary muscles |
| What is the external urethral sphincter supplied by? | The perineal branch of the pudendal nerve |
| What does the external urethral sphincter control? | The membranous urethra and is responsible for the voluntary holding of urine It is also attributed to the relaxation of the pelvic floor, including the sphincter urethrae |
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